Women's labour experiences and quality of care in relation to a prolonged latent phase of labour

Abstract

Aim: To describe primiparous and multiparous women's labour experiences and their perception of quality of intrapartum care, in relation to background characteristics and length of latent phase of labour prior to admittance to labour ward.

Design: A cross-sectional study.

Setting: A middle-sized hospital in a rural county in western part of Sweden.

Participants: Primiparous and multiparous women, both low-risk and risk, with a spontaneous onset of labour after gestational week 37+0 were included. In total, n = 1193 women were invited, and n = 757 responded the questionnaire, n = 342 primiparous and n = 415 multiparous women.

Methods: The Intrapartal-specific Quality from Patient Perspective (QPP-I), with responses on perceived reality and subjective importance, was used for data collection. QPP-I covers ten factors of quality of care. Background characteristics, length of latent phase of labour, global items about labour experience and items regarding feelings during labour and birth were included. Data were analysed with descriptive and analytic statistics.

Findings: All factors in QPP-I were rated higher for subjective importance than perceived reality, except for information about selfcare, for both primi- and multiparous women. Labour experience, perceived reality of quality of care, and feelings were related to length of the latent phase of labour. Primiparous women with a prolonged latent phase (>18 h) had significantly lower scores regarding six out of ten QPP-I factors (PR); Information procedures, Information self-care, Commitment (midwives), Commitment (enrolled nurses), Midwives present, and Partner/ significant others. They scored lower on Experience birth as normal and Safe during labour and birth. The felt less proud and felt more ignored by professionals. Multiparous women with a prolonged latent phase of labour scored significantly lower on one QPP-I factor, Commitment (midwives). They also scored lower on Control over the situation and felt less safe during labour and birth.

Key conclusion: Women's perception of quality of intrapartum care, the birth experience and feelings are related to length of the latent phase of labour. Women perceive quality of intrapartum care as being lower than its subjective importance.

Implications for practice: A prolonged latent phase of labour can be regarded as a risk factor for a more negative birthing experience.

Keywords: Birth experience; Early labour; Prolonged latent phase of labour; Quality of care.